Lyme Disease in Children

What is Lyme disease?

Lyme disease is an infection that your child can get if he's bitten by a tick carrying certain bacteria. Doctors call it the "great imitator" because it mimics other diseases, making it difficult to diagnose; in addition, a blood test can't confirm it until about three weeks following the bite. Left untreated, the infection can develop into a serious long-lasting illness that can cause nerve damage, arthritis, and heart problems such as irregular heartbeats. Fortunately, the disease is preventable and usually responds well to treatment.

Named for the Connecticut town where the illness was identified in 1975, Lyme disease has been diagnosed in virtually every state in the country, but the disease is most common in the Northeast, the Great Lakes region, and the Pacific Northwest, home to deer ticks (the tiny bloodsuckers that carry it). Some people worry so much about Lyme disease that they've given up hiking and camping in these areas, but that's no guarantee of safety: It's estimated that seven in ten victims are bitten in their own backyards. Lyme disease is a year-round problem, but the prime season for the disease is April to October, when ticks are most active.

How do kids get it?

When an infected tick bites your child, it can transmit the corkscrew-shaped bacteria that cause Lyme disease. (A tick larva, which looks like a sesame seed, can also spread the virus.) Finding and getting rid of the pest early helps prevent the illness, since the tick generally has to remain attached to its victim for about 24 hours to pass along the bacteria.

What are the symptoms?

Though it doesn't always appear, the most distinctive sign of Lyme disease is often a bulls-eye rash with raised edges and a pale center, which develops at the site of the tick bite. It may start as a fraction of an inch and increase to 5 to 6 inches in diameter; it may also appear in parts of the body far away from the tick bite. The rash can show up from two days to a month after the bite and may last a few hours or several weeks. But many people never get it at all. Instead, within a few weeks of being bitten, they suffer flu-like symptoms -- fever, chills, sore throat, and aching muscles and joints. After several weeks or months, more alarming symptoms may appear, including paralysis of the face, stiff neck, sensitivity to light, irregular heartbeat, fainting, numbness, and shooting or steady pain in the joints and muscles.

When should I call a doctor?

Call your pediatrician immediately if your child has symptoms of Lyme disease or if you find a tick that has been in longer than 6 hours. (Watch for symptoms of the rash, and notify your physician if a rash develops.) If the tick is still in his skin, you need to remove and preserve it properly; to find out exactly how, see tick bites.

How is Lyme disease diagnosed?

If your child has early symptoms of Lyme disease, the doctor may order a blood test to check for antibodies to the bacteria that cause the disease. Unfortunately, the test is not completely reliable, and a number of medications can interfere with the results. If the test is inconclusive, your pediatrician may recommend a course of antibiotics as a precaution. Many doctors, however, will suggest holding off on treatment while you watch your child carefully for further symptoms.

How is it treated?

Lyme disease is treated with antibiotics, either one drug or a combination. The early stage treatment for most children is 14 to 21 days. Treatment could be as long as four weeks for children with facial nerve paralysis or arthritis. If your child does develop arthritis, the doctor may have him take anti-inflammatory drugs such as ibuprofen for joint pain and inflammation.

Is there a vaccine?

The only vaccine for Lyme disease was removed from the market by the manufacturer in 2002 after slow sales. Reports of some people suffering from arthritis-like symptoms and muscle pain after receiving the vaccine may have contributed to slow sales; however, the Centers for Disease Control and Prevention found no safety issues with the vaccine.

Are there other ways to prevent the disease?

Yes. When your child plays outside, especially in grassy or wooded areas where ticks are common, he should wear light-colored clothing so the pests will be easier to spot. Shorts and sandals are an open invitation to ticks. Instead, your youngster should wear closed shoes, long pants, and long-sleeved shirts, and have him tuck his pants into his socks.

You can also spray an insect repellent containing 20 to 30 percent DEET on his clothing and -- sparingly -- on his exposed skin. (Since DEET is an insecticide, a few precautions are in order: Read the manufacturer's label carefully and never spray DEET on your child's face or hands; instead, spray it on your hands and then apply it to his face and neck, avoiding all contact with the eyes and lips. You should also avoid putting the insect repellent on sunburned skin, and don't apply it under your child's clothing. Washing your hands after applying it, and scrub or have your child scrub off the repellent when he's through playing outside.)

When your child comes in from playing, scrutinize his body for ticks, checking carefully in every nook and cranny -- his underarms, the backs of his knees, between his fingers and toes, in his belly button, on his neck and head, and behind his ears.

You can also try to create a tick-free zone around your house. For starters, clear away brush where ticks like to hide. Stack firewood away from the house, since woodpiles attract mice, which may carry ticks.

Further Resources

The Lyme Disease Foundation
PO Box 332
Tolland CT 06084-0332
(860) 870-0070
24-Hour Hotline: (800) 886-LYME
http://www.lyme.org/

American Lyme Disease Foundation
PO Box 466
Lyme, CT 06371
http://www.aldf.com/

Centers for Disease Control and Prevention
http://www.cdc.gov/ncidod/dvbid/lyme/index.htm

National Library of Medicine
http://www.nlm.nih.gov/medlineplus/lymedisease.html

References

Pantell, Robert H. M.D., James F. Fries M.D., and Donald M. Vickery M.D. Taking Care of Your Child: A Parent's Illustrated Guide to Complete Medical Care, Eighth Edition. Da Capo Lifelong Books.

Manufacturer Discontinues Only Lyme Disease Vaccine. FDA Consumer Magazine http://www.fda.gov/fdac/departs/2002/302_upd.html#...

Wormser G et al. Clinical Infectious Diseases. The Clinical Assessment, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: Clinical Practice Guidelines by the Infectious Diseases Society of America. 43:1089-1134.

Centers for Disease Control. Lyme Disease Statistics. http://www.cdc.gov/ncidod/dvbid/lyme/ld_statistics...

American Academy of Pediatrics. Lyme Disease. https://publications.aap.org/pediatrics/article-abstract/149/3/e2021054980/184752/Management-of-Pediatric-Lyme-Disease-Updates-From?redirectedFrom=fulltext